WHAT IS THE CAUSE OF SARS? ONE VIRUS, TWO VIRUSES WORKING IN CONCERT, OR A DETERMINANT UNKNOWN

PRO MED - WHO ^ | 03-25-03

[Mother Abigail]

Q. The question about the 2 viruses having been, or 2 families of viruses having been associated with this disease or with this outbreak. You said it was not normal, if I'm not mistaken. Could you give us an idea of whether or not it's possible for a single disease to be caused by 2 viruses or is it more likely that at least one of the samples might not be related to SARS?

A. Dr Klaus Stohr: Speaking as a scientist, we are looking at a very interesting and a fascinating situation. Looking from the point of infectious disease control, we are a bit puzzled because we are not only dealing apparently with one pathogen but with 2.

The reason why we believe that both pathogens should be given equal attention is that there is consistent finding of both pathogens in individual patients or of either of the pathogens in other patients.

What we are seeing actually are 3 hypotheses.

The first hypothesis is that one of the viruses, for instance the corona virus, causes the disease, and that might be a new corona virus.

The second hypothesis is that the paramyxoviruses cause the disease and if that was the case, it's certainly also a new paramyxovirus.

The third hypothesis, very obviously, is that these 2 pathogens have to come together to cause this very severe outbreak. One of the viruses, for instance the coronavirus, is known to live in immune cells, cells which are important for defense against infection. So what one could hypothesize is that this coronavirus destroys or at least diminishes the immunity in the patient so that the second virus has practically an open door to go in and to sicken the patient beyond what this virus would be able to do normally.

Dr David Heymann: Let me just add to that: there could be a fourth hypothesis. It is possible that both are common viruses: one found in all the patients, even though it's not causing disease, and the other will be the disease-causing agent, so they could both be found but not be related in any way, just there by chance. So it's a very complicated issue that's being sorted out.

[TaxRelief]

In the last couple years, there has been a tremendous amount of progress in the field of virology. Recently, there have been several breakthroughs on the Coronaviridae front. Coronavirus is very large (~30kb) and until recently has been difficult to clone. However by combining a recombinant vaccinia virus and fowl pox for instance, it has been possible to create a recombinant human coronavirus.

This sounds complicated, but the bottom line is there is a lot of research that involves combining viruses. Theoretically, the purpose of the research is to find cures for diseases that are not as easily vaccinated against, ie, measles, mumps and other simple viruses. However, the information on the recombinant research is readily available to anyone who chooses to fathom it and misuse it.

Mother Abigail: You are out of your element on the technical details and run the risk of misleading people. For instance, it is imperative that people at risk understand the means of transmission and dangers of paramyxovirus and coronavirus. One type of paramyxovirus may live harmlessly in humans, but not all paramyxovirus are harmless: measles, mumps, RSV are just three examples. Coronavirus is only responsible for 10 to 15% of cold viruses, but a host of other problems. Perhaps you should limit yourself to disseminating information while avoiding answering microbiology specific questions.

[Judith Anne]

bump to myself.

[gnarledmaw]

"But I also see a lot of use of the word "suspected" cases in these stories. How many of them are regular flu?"

Im thinking sort of just the opposite. Theres a bug going around that most, for one reason or another are just shrugging off and dont head in to the doctor and its only the more extreme cases being reported. There have been a number of cases of SARS reported here according to the local news channel. Supposedly there are just a few isolated cases...mulefritters.

Think about how a "normal flu" sweeps through your family and friends once someone gets it. In a couple of weeks, everyone in town has had it and its gone but for some reason SARS isnt apparently quite so contagious...not buying it.

Something has swept through here in the last week or so that doesnt sound like a "regular flu" to me but local swamped doctors are just shrugging it off as "some kinda virus". Temps up around 105, not a normal flu. Extreme near suffocation type phlegm, not a normal flu. Exhaustion of one or more body parts to the point of paralysis even in the young and otherwise healthy, not a normal flu. It arrived about the same time as the SARS reports and seems now to be working its way through.

Like you, Im guessing that it and the media coverage of it will be gone soon. Im just not buying the official version of the story.

[EternalHope]

Yes, some people been released. I do not know what percentage.

Yes, there is precedent for a disease getting weaker as it works its way through the population.

I am not a doctor, although I have a lot of experience and training in statistics, specifically including bio-statistics. For specific medical information, FreeRepublic has a number of medical experts, such as Mother Abigail, providing information on this. They are an outstanding source of information.

[Mother Abigail]

Thank you for your imput

[Mother Abigail]

Lubbock woman contracts mysterious SARS illness

Associaed Press

LUBBOCK -- A Lubbock woman is the third Texan to have contracted a suspected case of severe acute respiratory syndrome, or SARS, Lubbock city officials have confirmed.

The Texas Department of Health contacted the Lubbock Health Department about the woman on Saturday. The syndrome has not shown up in Lubbock, said Ken Condon, an epidemiologist for the Lubbock Health Department.
"It's simply a connection with Lubbock, not a case in Lubbock"

[apologist]

Something has swept through here in the last week or so that doesnt sound like a "regular flu" to me but local swamped doctors are just shrugging it off as "some kinda virus". Temps up around 105, not a normal flu. Extreme near suffocation type phlegm, not a normal flu. Exhaustion of one or more body parts to the point of paralysis even in the young and otherwise healthy, not a normal flu. It arrived about the same time as the SARS reports and seems now to be working its way through.

What part of the country are you in?

[Mother Abigail]

Singapore's Health Ministry has confirmed the country's second Severe Acute Respiratory Syndrome-related death.

It is understood the man, one of the first SARS victims, is a 39-year-old pastor of the Faith Assembly of God Church at Kim Keat Road.

This was confirmed by several members from his church.
The second fatality comes a day after the SARS claimed its first victim in Singapore.

This patient, a man in his 40s to 50s, died of lung failure under intensive care at Tan Tock Seng Hospital on Tuesday night.

He has already been cremated.
The director of medical services says anyone who dies from SARS will undergo an autopsy and be cremated immediately.

At a media conference, Health Minister Lim Hng Kiang declined to confirm if the first victim was the father of one of the index cases, nor would he give details of the death.
He added that the ministry wanted to

[Mother Abigail]

Marin County may have its first case of SARS

The Associated Press

-- Marin County is reporting its first suspected case of the mysterious new super-pneumonia known as SARS.

Health officials say the patient recently visited Hong Kong and China. That patient apparently had a relatively mild case and is recuperating at home.

Thirty-nine cases have been confirmed in the U.S. -- with eleven in California.
The total worldwide is approaching 500 -- with 52 deaths reported

[Mother Abigail]

Two Theories Eyed in Illness

By Laurie Garrett

STAFF WRITER

March 26, 2003

Officials pursuing the cause of the mysterious illness reported in 13 countries so far offered two possible theories yesterday to explain the findings of three disparate viruses:

The disease could be caused by a combination of typically benign viruses, producing a virulent double impact on the human immune system.

Or, more puzzlingly, none of the viruses found so far is to blame - that these microbes may be so common that their presence in patient tissue specimens is simply a coincidence

[Mother Abigail]

BOOKMARK

[Mother Abigail]

More...

German and Hong Kong scientists so far have found a virus that belongs to the paramyxovirus family, which includes measles.

The U.S. Centers for Disease Control and Prevention has identified a coronavirus, suggesting that the disease is caused by new mutant form of a common cold virus.

A lab in Canada has found a metapneumovirus, known to produce fairly mild sniffles and sore throats in children, though severe cases leading to pneumonia have been reported.

[apologist]

Or, more puzzlingly, none of the viruses found so far is to blame - that these microbes may be so common that their presence in patient tissue specimens is simply a coincidence

I'm curious why it's so hard to find the culprit; if it's so contagious (which it seems to be), shouldn't a patient just be able to cough up a bunch of whatever viruses (virii?) are being spread around?

[CathyRyan]

ProMED has a new update

http://www.promedmail.org/pls/askus/f?p=2400:1001:185689623850806621::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,21086

[per loin]

This from the Hong Kong Standard:

Medical Association president and legislator Lo Wing-lok says it is too late for Hong Kong to follow Singapore and implement forced isolation to try to control the outbreak of viral pneumonia.

[CathyRyan]

not good

[dinodino]

Er...have you been in a cave for the past few weeks? Just curious.

[per loin]

Not good at all. Korea just reported its first suspected case, and India has installed medical screening teams at all its international airports. BTW, 3M says its masks will not stop a virus, but they should stop the droplets that carry the virus. However as soon as a mask stops those droplets, it itself can become a source of contamination.

I'd guess that we are within a few days of hearing rumors of people starting to flee Hong Kong. Wish I had a good source on comparative passenger loads in and out. That would give a more accurate picture of the public feelings in that city than we are getting from the media.

[EternalHope]

Medical Association president and legislator Lo Wing-lok says it is too late for Hong Kong to follow Singapore and implement forced isolation to try to control the outbreak of viral pneumonia.

!!!!!!!

Lets make a few simple assumptions (a full analysis would be much more complex). Doubling time = 10 days, 300 people in Hong Kong are infected as of today.

That would mean we would have 2,400 cases in one month. Probably low enough to keep the lid on, and the hospital system can probably still cope (sort of). Anything that can possibly be done to isolate infected people should have been already instituted by this point (at the latest!).

If it continues to double every 10 days, in two months we will have 76,800 cases. Hong Kong will have panicked, and the hospital system will have been overwhelmed. World travel restrictions will have been instituted.

So... What is the doubling time for this disease, and what is the death rate once the hospital system has been overwhelmed?

Sure hope we never get to find out...

[maestro]

Is there 'Monkey' (primate) measles?